Effects of antithrombotic drugs on the results of fecal immunochemical test in colorectal neoplasms screening

Takashi Ibuka,Hiroshi Araki,Masamichi Arao,Midori Iwama,Tomohiko Ohno,Seiji Adachi,Koshiro Saito,Eri Takada,Koji Takai,Masahito Shimizu,Yohei Horibe,Masatoshi Mabuchi,Yusuke Suzuki,Osamu Yamauchi

doi:10.1038/s41598-021-83007-4

Takashi Ibuka, Hiroshi Araki + Show 12 more

Open Access

https://doi.org/10.1038/s41598-021-83007-4

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Journal: Scientific Reports	Publication Date: Feb 23, 2021
Citations: 3	License type: open-access

Affiliation: Gifu University

Abstract

Fecal immunochemical test (FIT) is widely used as a colorectal cancer screening tool. Antithrombotic drugs may affect the screening performance of FIT for colorectal tumors. The aim of this study was to clarify the effect of antithrombotic agents on FIT accuracy in screening for colorectal neoplasms. This retrospective study enrolled a total of 758 patients who underwent both FIT and total colonoscopy. The effect of antithrombotic drugs on FIT accuracy in detecting colorectal neoplasms (CN), including colorectal cancer (CRC), advanced adenoma (AA), and non-advanced adenoma (NAA), was examined. Of the 758 patients, 144 (19%) received antithrombotic drugs (administration group). In administration group, 61/144 (42%) cases had CN [CRC:14, AA:15, NAA:32] and 217/614 (35%) cases had CN (CRC:43, AA:56, NAA:118) in non-administration group. The prevalence of CN was not significantly different between the two groups (p = 0.1157). There was no significant difference in sensitivity or specificity of the detection of all types of CN with or without taking antithrombotic drugs. Neither the positive predictive value nor negative predictive value of FIT was affected by antithrombotic drug administration. Taking antithrombotic drugs may not have a large impact on sensitivity, specificity, positive predictive value, or negative predictive value of FIT in screening for CN.

Highlights

Fecal immunochemical test (FIT) is widely used as a colorectal cancer screening tool
Among the 758 patients who underwent both FIT and total colonoscopy, 144 patients were treated with antithrombotic drugs
Complication rates of diabetes mellitus (31.3% vs. 10.1%, p < 0.0001), hypertension (62.5% vs. 33.7%, p < 0.0001), and hyperlipidemia (31.3% vs. 17.8%, p = 0.0003) were significantly higher in the administration group compared to the non-administration group

Summary

Introduction

Fecal immunochemical test (FIT) is widely used as a colorectal cancer screening tool. The aim of this study was to clarify the effect of antithrombotic agents on FIT accuracy in screening for colorectal neoplasms. The effect of antithrombotic drugs on FIT accuracy in detecting colorectal neoplasms (CN), including colorectal cancer (CRC), advanced adenoma (AA), and non-advanced adenoma (NAA), was examined. Neither the positive predictive value nor negative predictive value of FIT was affected by antithrombotic drug administration. Taking antithrombotic drugs may not have a large impact on sensitivity, specificity, positive predictive value, or negative predictive value of FIT in screening for CN. Abbreviations CRC Colorectal cancer FIT Fecal immunochemical test CN Colorectal neoplasms DOAC Direct-acting oral anticoagulant PPV Positive predictive value AA Advanced adenoma LDA Low-dose aspirin NAA Non-advanced adenoma NPV Negative predictive value. Accurately reflecting the presence of CN in the results of FIT is extremely important in determining the need for colonoscopy and treatment, such as polypectomy, of these lesions

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